title: Selection criteria for selective dorsal rhizotomy in children with spastic cerebral palsy: a systematic review of the literature.
abstract: OBJECTIVE
  Information regarding the selection procedure for selective dorsal rhizotomy (SDR) in children with spastic cerebral palsy (CP) is scarce. Therefore, the aim of this study was to summarize the selection criteria for SDR in children with spastic CP.
  
  
  METHODS
  A systematic review was carried out using the following databases: MEDLINE, CINAHL, EMBASE, PEDro, and the Cochrane Library. Additional studies were identified in the reference lists. Search terms included 'selective dorsal rhizotomy', 'functional posterior rhizotomy', 'selective posterior rhizotomy', and 'cerebral palsy'. Studies were selected if they studied mainly children (<18y of age) with spastic CP, if they had an intervention of SDR, if they had a detailed description of the selection criteria, and if they were in English. The levels of evidence, conduct of studies, and selection criteria for SDR were scored.
  
  
  RESULTS
  Fifty-two studies were included. Selection criteria were reported in 16 International Classification of Functioning, Disability and Health model domains including 'body structure and function' (details concerning spasticity [94%], other movement abnormalities [62%], and strength [54%]), 'activity' (gross motor function [27%]), and 'personal and environmental factors' (age [44%], diagnosis [50%], motivation [31%], previous surgery [21%], and follow-up therapy [31%]). Most selection criteria were not based on standardized measurements.
  
  
  CONCLUSIONS
  Selection criteria for SDR vary considerably. Future studies should describe clearly the selection procedure. International meetings of experts should develop more uniform consensus guidelines, which could form the basis for selecting candidates for SDR.
authors.affiliation: Department of Paediatric Neurology, University Children's Hospital, Berne, Switzerland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Grunt
authors.forename: A Graham
authors.initials: AG
authors.lastname: Fieggen
authors.forename: R Jeroen
authors.initials: RJ
authors.lastname: Vermeulen
authors.forename: Jules G
authors.initials: JG
authors.lastname: Becher
authors.forename: Nelleke G
authors.initials: NG
authors.lastname: Langerak
mesh_terms: D002547:Cerebral Palsy / Q000601:surgery*; D016208:Databases, Factual / Q000706:statistics & numerical data; D006801:Humans; D019051:Rhizotomy / Q000379:methods*; D013126:Spinal Nerve Roots / Q000502:physiology / Q000601:surgery*